Treatment for young children who stutter
About how long is the recommended "special time" or "listening time" for parents/preschool children who stutter?
10-15 minutes
Give an example of a verbal contingency for fluency in the Lidcombe program
"that was smooth talking."
What are two types of fears often seen in a school age child who stutters?
word fears, situational fears
What is spontaneous fluency?
Speech without stuttering where the speaker does not have to think about it.
Name one difference between neurogenic stuttering and developmental stuttering
Neurogenic stuttering
- sudden onset in adulthood
- stuttering may occur with similar frequency on function and content words
- stuttering is less restricted to the initial syllables of words
- repeated readings of the same passage have less of an effect on neurogenic stuttering, many fluency-inducing conditions do not reduce stuttering
- there is little fear and few secondary behaviors.
- Effective therapy may include surgery and drug adjustments for the underlying neurological problem as well as behavioral approaches, such as pacing or slowing speech.
What are three parent-child interaction patterns that you may change to reduce communication pressure for a preschool child who stutters? (several possible answers)
fast speech, lack of pauses, interrupting, frequent questions, directive or critical comments, inconsistent listening behaviors, high level vocabulary or syntax.
Give an example of a verbal contingency for unambiguous stuttering in the Lidcombe program
"that was a little bumpy"
This technique is when you start a sentence with a gentle start of voicing vs. glottal attack. Name the technique
What is an easy onset?
A term (2 words) that means consciously going towards something that was previously (or is currently) feared.
What is approach behavior?
List two possible causes of neurogenic stuttering.
stroke, head trauma, tumor, disease processes such as Parkinson’s, or drug toxicity. dialysis dementia, seizure disorders, bilateral thalamotomy, or thalamic stimulation, combat-related brain injury and co-occurring posttraumatic stress disorder (PTSD)
(Any 2 of these)
What are 2 changes a family can make to reduce communication pressure for a child who stutters?
listening, slow rate, increased pauses, positive comments, reduced # of questions, decrease interruptions, decrease corrections,
5:1
This term means a person has an awareness of the feeling of speech (e.g. jaw and tongue movement) instead of relying on auditory feedback alone.
What is proprioception?
What is controlled fluency?
A highly conscious way of talking that induces fluency by modifying a person's speech
In psychogenic stuttering, a person is faking (pretending to stutter). True or false?
False
What are two family routines that might be adjusted to support a child's fluency? (there are several)
Add in special time, slow pace of life, adequate rest, clear and consistent discipline, time for transitions (to decrease rushing), consistent naptimes, meals, etc.
How long does stage 2 of the Lidcombe program take?
Typically a year
When a school age child does voluntary stuttering including slides and pullouts to regain a sense of control over stuttering this is called...
"controlled stuttering"
Describe 3 characteristics of advanced stuttering? Think about:
- length of time stuttering?
- speech patterns?
- behavior patterns?
- thoughts/emotions?
1) who have been stuttering for many years.
2) speech patterns consist of blocks, repetitions, and prolongations accompanied by tension and struggle as well as escape and avoidance behaviors.
3) Typically, these individuals have developed negative anticipations about speaking situations and listener reactions.
4) Sometimes, have chosen occupations or interests beneath their abilities to avoid stuttering
A person with this type of disfluency will often benefit from a pacing board and rhythmic tapping to increase fluency.
Neurogenic stuttering
How does more severe borderline stuttering in preschool children differ from stuttering at this age?
In borderline stuttering, the child doesn't show physical tension or escape behaviors related to stuttering.
What is a primary measure of change in a child's speech in the Lidcombe program?
Severity ratings of the child's speech
List one of van riper's key concepts of therapy with a school age child:
1) fear and avoidance are important factors
2) reduce struggle
3) reduce shame through openness
4) keep it fun
5) clinicians perform any tasks they ask the child to do
Hierarchies of least to most difficult speaking situations rely on what behavioral principle?
A person with this type of fluency disorders may show increased stuttering in a condition that typically results in increased fluency. What is the condition?
Psychogenic stuttering
What is the average age of onset for stuttering in young children?
2 years;8 months
List 2 core behaviors of stuttering
repetitions, prolongations, interjections, revisions, blocks
What does the term "adaptation" mean in reference to stuttering?
A person who stutters will stutter less each time he/she reads the same passage out loud
A adolescent or adult may often feel "trapped" in a stutter. What intervention method is used to decrease the fear and struggle associated with getting stuck in a stuttering moment?
List 3 common features of cluttering (there are many)
disorganized language
many "mazes"
false starts, hesitations, and revisions
rapid rate
imprecise articulation
List 2 behaviors that increase a child's likelihood of persistent stuttering?
- stuttering longer than 12 months
- family history
- gender = boy
- 10% or greater disfluencies
- greater than 50% atypical disfluencies
- concomitant speech/language delays
- temperament
- environmental factors
List 2 secondary behaviors that can be associated with stuttering in children and/or adults
physical behaviors to escape stuttering (eye blinks, head nods, etc.)
negative emotions
Negative thoughts
avoidance behaviors
What percentage of people who stutter have a family history of someone who stutters?
30-60%
What two things are measured in the Camperdown approach?
1) speech naturalness rating or level of fluency technique rating (no technique to training model of technique)
2) stuttering severity
In cluttering, what are some focus areas of treatment? List 2.
Decreasing speech rate
Increased monitoring of speech rate
Linguistic fluency - organization of ideas and turn-taking
Tune in to listener non-verbal signals
Delayed auditory feedback to decrease rate
Increase knowledge and awareness of his/her cluttered speech